title: Adenoid cystic carcinoma of the salivary gland: a clinicopathological study of 49 cases and of metallothionein expression with regard to tumour behaviour.
abstract: OBJECTIVE
  Adenoid cystic carcinoma (AdCC) of the salivary glands shows heterogeneous behaviour, with metastasis as a key indicator of poor prognosis. Metallothionein (MT) expression has been associated with poor prognosis of diverse neoplasms. We evaluated prognostic factors for AdCC and the role played by MT, focusing on metastatic behaviour.
  
  
  RESULTS
  We reviewed the files of the Brazilian National Institute of Cancer between 1997 and 2004, obtaining 49 cases. Fourteen tumours had metastasized during follow-up. Among these, we identified cases presenting with metastasis at patient admission as showing the poorest survival rates. MT immunostaining of the tumours was performed (using the E9 antibody), and evaluated for the parameters of proportion, intensity and distribution in tumour cells. Extent and intensity of staining, and Quickscore (a combined measure of extent and intensity), were higher in metastatic than non-metastatic tumours (for Quickscore, P = 0.044), with highest values found for cases of early metastasis. Most cases showing weak staining, and all with a predominantly cytoplasm-restricted staining pattern, were non-metastatic. Metastatic tumours of solid type received higher scores than solid non-metastatic (Intensity, P = 0.0239; Quickscore, P = 0.0481).
  
  
  CONCLUSIONS
  Our results demonstrated metastasis to be the most significant indicator of poor prognosis and deterioration for AdCC. Consistent patterns of MT expression were observed to correlate with metastatic behaviour, indicating that MT may potentially serve as a prognostic marker for AdCC.
authors.affiliation: Pathology Post-graduate Programme, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Marco Túllio
authors.initials: MT
authors.lastname: Brazão-Silva
authors.forename: Sérgio Vitorino
authors.initials: SV
authors.lastname: Cardoso
authors.forename: Paulo Rogério
authors.initials: PR
authors.lastname: de Faria
authors.forename: Fernando Luiz
authors.initials: FL
authors.lastname: Dias
authors.forename: Roberto Araújo
authors.initials: RA
authors.lastname: Lima
authors.forename: Ana Lúcia Amaral
authors.initials: AL
authors.lastname: Eisenberg
authors.forename: Marilena Filgueira
authors.initials: MF
authors.lastname: Nascimento
authors.forename: Adriano Mota
authors.initials: AM
authors.lastname: Loyola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D003528:Carcinoma, Adenoid Cystic / Q000378:metabolism* / Q000473:pathology* / Q000556:secondary; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008668:Metallothionein / Q000378:metabolism*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000378:metabolism* / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D008668:Metallothionein
keywords: adenoid cystic carcinoma; head and neck cancer; metallothionein; neoplasm metastasis; salivary gland neoplasms